RESUMO
Lack of clear clinical and laboratory picture of subjective evaluation of bowel viability, the progression of bowel necrosis in the postoperative period with acute mesenteric ischemia (ÐÐI) contributes to the high mortality rate. Earlier experiments we proved that gut necrosis leads to changes in the subpopulation structure of blood lymphocytes. This prompted us to determine the clinical significance of the subpopulation structure of venous blood lymphocytes in patients with acute mesenteric ischemia. The paper is based on a retrospective analysis of the results of a controlled clinical and immunological examination of 18 patients aged 62 to 78 years (control group and a group of ÐÐI). Evaluation lymphocyte subpopulation structure was performed by the standard method of direct immunofluorescence staining of whole blood. The obtained data were processed with nonparametric statistical methods. Study of lymphocyte subpopulation structure in patients with ÐÐI patients showed a decrease in the absolute and relative number of CD8, CD4, B, NK cells on the indicators in the control group. Ischemia and necrosis of the intestinal mucosa accompanied by a massive translocation of intestinal microflora through the impaired intestinal barrier along with the migration of lymphocytes into the lesion and death, which is manifested in a decrease in the number of lymphocytes of the peripheral blood. Comprehensive assessment of venous blood lymphocyte subpopulation structure can be used as an additional diagnostic criterion necrotic step ÐÐI, serve as criteria for selection of patients for immunotherapy.
Assuntos
Intestinos/patologia , Isquemia Mesentérica/diagnóstico , Idoso , Movimento Celular , Humanos , Contagem de Linfócitos , Linfócitos/citologia , Pessoa de Meia-Idade , Estudos RetrospectivosRESUMO
The serum levels of some indices of the LPO antioxidant system (dienic conjugates, antioxidative activity), cytokines (IL-1beta, TNF-alpha, IL-4) and the blood antiprotease system protein alpha2-macroglobulin were studied in 97 patients with closed long bone fractures. Based on the finding, a procedure was devised to evaluate the course of an inflammatory process in the early postoperative period, which predicted the development of pyoinflammatory complications at a stage of preclinical manifestations.
Assuntos
Antioxidantes/metabolismo , Citocinas/sangue , Fraturas Ósseas/sangue , Inflamação/sangue , Inflamação/diagnóstico , Adulto , Feminino , Fraturas Ósseas/complicações , Fraturas Ósseas/diagnóstico , Fraturas Ósseas/cirurgia , Humanos , Inflamação/etiologia , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/sangue , Complicações Pós-Operatórias/diagnóstico , Período Pós-OperatórioRESUMO
Interleukine (IL-1alpha, IL-4) blood levels and lipid peroxidation--antioxidant agents were assessed in 98 patients with fractures of long tubular bones. Using the data, an algorithm was worked out, which permits prediction of septic complications with a high level of accuracy.
Assuntos
Fraturas Ósseas/cirurgia , Fraturas Fechadas/cirurgia , Interleucina-1alfa/sangue , Interleucina-4/sangue , Infecção da Ferida Cirúrgica/diagnóstico , Fraturas Ósseas/sangue , Fraturas Ósseas/classificação , Fraturas Fechadas/sangue , Fraturas Fechadas/classificação , Humanos , Peroxidação de Lipídeos , Prognóstico , Supuração/sangue , Supuração/diagnóstico , Infecção da Ferida Cirúrgica/sangueRESUMO
An investigation of the content of interleukins (IL-1alpha, IL-4) in blood serum, indices of the system of "LP-antioxidants" (DC, AOA) was performed in 92 patients with open fractures of long tubular bones. A method of early diagnosis of purulent complications in the postoperative period was worked out which allows timely necessary correction to be introduced in the plans of treatment.
Assuntos
Fixação de Fratura/métodos , Fraturas Ósseas/cirurgia , Fraturas Expostas/cirurgia , Infecção da Ferida Cirúrgica/diagnóstico , Fraturas do Fêmur/cirurgia , Seguimentos , Humanos , Fraturas do Úmero/cirurgia , Estresse Oxidativo , Prognóstico , Fraturas do Rádio/cirurgia , Supuração , Infecção da Ferida Cirúrgica/etiologia , Infecção da Ferida Cirúrgica/metabolismo , Fraturas da Tíbia/cirurgiaAssuntos
Citocinas/sangue , Fraturas Expostas/diagnóstico , Infecção da Ferida Cirúrgica/diagnóstico , Abscesso/complicações , Abscesso/diagnóstico , Abscesso/imunologia , Adulto , Algoritmos , Celulite (Flegmão)/complicações , Celulite (Flegmão)/diagnóstico , Celulite (Flegmão)/imunologia , Extremidades/lesões , Feminino , Fraturas Expostas/complicações , Fraturas Expostas/imunologia , Humanos , Masculino , Pessoa de Meia-Idade , Osteomielite/complicações , Osteomielite/diagnóstico , Osteomielite/imunologia , Periostite/complicações , Periostite/diagnóstico , Periostite/imunologia , Valor Preditivo dos Testes , Prognóstico , Infecção da Ferida Cirúrgica/imunologiaRESUMO
Under study was the influence of cytomedins on the system of immunity in patients with developed surgical infection in a traumatology clinic. The investigation of immune reactions under conditions of purulent infection of different etiology has shown the necessity to include the up-to-date and purposeful immunomodulating therapy (cytomedins) in the complex of treatment which allows arrest of the inflammatory process in the wound in earlier terms.
Assuntos
Peptídeos/imunologia , Peptídeos/uso terapêutico , Infecção da Ferida Cirúrgica/tratamento farmacológico , Cicatrização/efeitos dos fármacos , Adolescente , Adulto , Antiulcerosos/uso terapêutico , Terapia Combinada , Feminino , Humanos , Masculino , Infecção da Ferida Cirúrgica/imunologia , Infecção da Ferida Cirúrgica/terapia , Fatores de Tempo , Resultado do Tratamento , Cicatrização/imunologiaRESUMO
Effect of tissue ischemia on immunity was studied in patients with developing surgical infection after injuries. Tissue hypoxia is one of the factors promoting the formation of immunity failure. Study of the course of immune reactions under conditions of hypoxia in suppurative infection of different etiology opens new diagnostic criteria and demonstrates the necessity of a differentiated approach to immunomodulating therapy of patients with local and total surgical infections of different etiology.